Prophylactic High‐Dose Oral‐N‐Acetylcysteine Does Not Prevent Atrial Fibrillation after Heart Surgery

• DOI: 10.1111/pace.12190
• Publication Date: 2013-06-03T19:45:27Z
• Authors: BABAK KAZEMI; FARIBORZ AKBARZADEH; NASER SAFAEI; ALIREZA YAGHOUBI; KAMRAN SHADVAR; KAMRAN GHASEMI
• Keywords: Etiology

Aims Postoperative atrial fibrillation (POAF) following cardiac surgery is a frequent complication with multifactorial etiologies. Recently inflammation due to enhanced oxidative stress has been implicated in its pathogenesis. N‐acetylcysteine (NAC) promising and novel antioxidant agent. The purpose of this study was evaluate the efficacy high‐dose oral‐NAC for prevention POAF. Methods Two hundred forty patients were randomized prospective, double blind placebo‐controlled trial either 1,200‐mg two times day (n = 120) or placebo starting 48 hours before up 72 after open heart surgery. Results mean age about 60 years, 75% male. Patients NAC group older, higher percentage acute coronary syndrome, hypercholesterolemia, left internal mammary artery use. Coronary involvement hypertension more prevalent group. All other baseline patient characteristics similar between groups. Overall POAF developed 13.8% patients. There no difference incidence vs groups (11.7% 15.8%, respectively; P 0.34). hospital stay, morbidity, mortality both Conclusions Prophylactic begun 2 days continued 5 days, had significant effect on POAF, in‐hospital postoperative morbidity mortality.